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Tuesday, May 31, 2011

Using Your IPad or Playbook May Disrupt Sleeping Habits

By Dr. James Aw

My first encounter with technology’s ability to affect sleep happened when I was an intern on my first surgical rotation, which included frequent 24-hour shifts. To allow interns like me to catch a few hours rest, the hospital gave us pagers. I toted the little black plastic box into the call room, flopped down on a cot and closed my eyes. But I couldn’t sleep. Was the pager about to beep? What if I slept through it? The mere presence of the technology induced such anxiety that I couldn’t drift off.

I wasn’t controlling the device; the device was controlling me. Something similar seems to be happening with today’s tablet computers. The portability of Apple’s iPad and Research in Motion’s PlayBook encourages us to take the tablet with us to bed. Many of us have replaced a good book with the iPad as the last media our eyes meet before dark. A U.S. poll released in March by the National Sleep Foundation estimated that 61% of people used some form of computer a few nights a week in the hour before bed. In fact, nearly half of adults in their twenties surfed the Internet every night, or almost every night, within the hour they went to sleep.

All that computer use may be harming our ability to perform the mental switch-off sleep requires — which could make us less productive and more irritable during the day.

Dr. Michael Gradisar is a psychology professor at Australia’s Flinders University and an expert on the sleep effects of interactive media. His research indicates that passive media — classically, books — are good for lulling us to sleep. But Gradisar says more interactive media, such as video games, cellphones or Web-browsing devices, “are more alerting and disrupt the sleep-onset process.”

One of the most comprehensive studies I was able to find about this was a Belgian study published in 2006 in the Journal of Paediatrics and Child Health. Based on a survey of 2,546 children in Grades 7 and 10, the study investigated media use as a sleep aid and how it related to fatigue. Respondents who said they used as sleep aids such activities as television-watching, computer-gaming and music-listening each reported decreased number of hours of sleep per week and increased self-reported levels of tiredness.

Disturbed sleep patterns may lead to daytime sleepiness, poor school results and behaviour problems for children. Other studies have shown children’s poor sleep patterns can carry over into adulthood. Interestingly, reading books in bed did not negatively affect sleep. “Although the respondents report using television, computer games and music as a sleeping aid,” the researchers noted, “the results suggest that there is no reason to assume that these media are really helping them sleep.”

Several theories attempt to explain how bedroom media use affects sleep patterns. The “displacement” hypothesis suggests that time spent consuming media displaces time spent conducting other activities, such as sleeping. Another theory suggests interactive media creates a state of hyper-arousal and cognitive stimulation just as we’re supposed to be winding down. Dealing with work-related email before bed, or in bed, also can lead to sleep-delaying cognitive stimulation. Finally, lying in bed with a multimedia device can cause such ergonomic challenges as neck and arm strain if the activity is not conducted in a comfortable position.

“Ah,” says the diehard iPad user. “At night, I only use the iPad to read e-books. That’s OK, right?” Maybe not. Darkness is an important component in the circadian rhythm that sees us transition from sleep to wakefulness and back again. That’s because darkness triggers the pineal gland’s production of melatonin, a hormone that suppresses body temperature and heart rate and in general promotes sleep. A growing body of research indicates the sort of light projected from backlit computer screens could be enough to suppress melatonin production, in turn disrupting our natural circadian rhythms.

The effect may be strengthened when the computer display is held as close to the face as iPads and PlayBooks tend to be. For example, a Swiss-German study published in March in the Journal of Applied Physiology established that exposure to light from a backlit LED computer screen prolonged wakefulness even over non-LED screens. (The test was conducted with a Hewlett-Packard screen. Apple’s iPad also has an LED screen.) Interestingly, dedicated e-book readers such as the Kobo or the Kindle, which are not backlit and do not function as light sources, probably wouldn’t create this effect.

I’m not criticizing the use of tablet computers. I think mine is great. Studies have shown the media they store can promote health — from humorous TV shows and clips that help people deal with stress and depression to video games helping children deal with the pain of severe burns. They’ve also been shown to assist in stroke rehabilitation.

But we’re fooling ourselves if we think tablet computers work as sleep aids. The general rule? If you’re serious about your night’s sleep, leave technology outside the bedroom. No TV, no video games, certainly no tablet computer. Instead, protect the bedroom as a sanctuary. Treat it as your space to restore, relax and recharge the old-fashioned way, with soothing bedtime activities, such as a great book, which can ease the body’s transition into a long night of calm and rejuvenating sleep.

• Dr. James Aw is the medical director of the Medcan Clinic, a leading private health clinic in Toronto. For more information, visit medcan.com.

Special to National Post May 31, 2011 – 7:00 AM ET | Last Updated: May 30, 2011 6:00 PM ET